Individual
DR. MOHAMMAD OTAHBACHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3620 I-27, LUBBOCK, TX 79404-2348
(806) 725-5985
(806) 725-5991
Mailing address
3420 22ND PL, LUBBOCK, TX 79410-1314
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
M7496
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8CV654
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/30/2007
Last updated
07/11/2011
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